Efficacy and adverse events of azacitidine in the treatment of hemodialysis patients with high-risk myelodysplastic syndrome

YOSHIHIRO Tomoyasu, MUTA Tsuyoshi, AOKI Kenichi, SHIMAMOTO Syo, TAMURA Yasuhisa, OGAWA Ryosuke

doi:10.11406/rinketsu.57.1004

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維持透析中の高リスク骨髄異形成症候群におけるazacitidineの有効性と有害事象
症例報告維持透析中の高リスク骨髄異形成症候群におけるazacitidineの有効性と有害事象
ショウレイホウコクイジトウセキチュウノコウリスクコツズイイケイセイショウコウグンニオケル azacitidine ノユウコウセイトユウガイジショウ

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<p>We describe two hemodialysis patients with high-risk myelodysplastic syndrome (MDS) treated with azacitidine. A 65-year-old woman (case 1) received azacitidine at 75 mg/m² for 7 days, and a 52-year-old man (case 2) with liver cirrhosis received a 70% dose of azacitidine. Both cases developed grade 4 cytopenia, but they achieved transfusion independence after 3 and 2 courses, and the durations of remission were 10 and 11 months, respectively. Case 1 had the complication of febrile neutropenia (FN) twice during the 1^st and 2^nd courses, but continued to receive azacitidine treatment thereafter. Case 2 developed infectious peritonitis during the sixth course, and azacitidine treatment was thus discontinued. After a 4-month treatment interruption, he became transfusion-dependent, and re-induction of azacitidine was successful. Of note, the course of case 1 was complicated by erythema nodosum on admission, which then disappeared after one course of azacitidine treatment. The mean durations of hospitalization were 17.5 and 23 days per course of azacitidine treatment, respectively. Though there are few reports of azacitidine treatment for hemodialysis patients with high-risk MDS, we advocate administering azacitidine to such patients, while paying close attention to the dose intensity of azacitidine and taking prompt action to manage infectious complications.</p>

Journal

Rinsho Ketsueki

Rinsho Ketsueki 57 (8), 1004-1010, 2016

The Japanese Society of Hematology

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